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General NPI Number Information
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NPI Number | 1700770047
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Entity Type | Individual
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Provider Name | JENNIFER DAWSON
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Gender | Female
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/07/2025
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Provider Practice Location Address
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Address Line | 154 WREN ST
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City | BARNWELL
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State | SC
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Zip | 29812-1527
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Country | US
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Telephone | 803-259-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 7361 ROUND STONE DR
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City | GRANITEVILLE
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State | SC
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Zip | 29829-6045
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Country | US
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Telephone | 508-508-9812
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Fax | 508-508-9812
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 30316
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License Number State | SC
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